Using Tuina for treating fever in children Anat Regev Dipl. CM (I.A.TCM) dip.ac.ch@gmail.com +972-50-724-0140 Special thank to Mr. Ran Razy
Fever in children Children get sick After fever illnesses we usually notice a developmental leap as well as cognitive and emotional changes
Western medicine Fever is common in children, and is not necessarily an indication of acute disease requiring treatment, unless accompanied by substantial changes in appearance/ behavior, or by other symptoms such as difficulties in breathing or loss of consciousness The fever s level (temperature) does not indicate the severity of the disease. Fever is a natural defense mechanism of the body, and a tool for it to fight infection The immune system functions better and faster with fever. The fever will drop when the infection is overcome A child with fever should be encouraged to rest If he refuses to eat, it is important to keep him hydrated
Going to see the doctor Babies under 2 months old, with a fever of over 37.8C should be taken to the doctor immediately. In all other cases, you should go to see the doctor if the fever persists for over 3 consequent days, or if it is accompanied by symptoms like vomiting, diarrhea, breathing difficulties, coughing (for several days) and other symptoms not like in a common cold. In addition, if the child shows great unrest, irritability and looks and behaves very sick (shakes, twitches or makes other odd movements)
What s so bad about Paracetamol? Fever caused by a virus or a bacteria will be accompanied by other symptoms like mild coughing, congested nose, tearing eyes Fever reducing drugs are usually given to alleviate the discomfort caused by these symptoms, but they might get in the way of the body s natural defense system, and its effort to heal itself. The fever will not rise indefinitely (in most case will not rise over 40.6C), and is not a threat for the body, nor will it cause any irreversible damage at these temperatures. Taking drugs that would alleviate the discomfort, would also deny the child of the rest he needs for healing. Reducing the fever will not make the recovery of the disease faster Consider giving such drugs if the child is exhausted of the fever, or at night if it interferes with his sleep (or the parents )
When to return a child to kindergarten? Children should remain at home for at least 24 hours without fever Sending them back before they are back at their strength might expose them to recurring or additional illnesses
Chinese medicine Tai Yang is affected by external pathogenic factor, along with weakness of Wei Qi and Zheng Qi Treating children for fever can alleviate the discomfort caused by the fever, and release the external pathogen The treatment strengthens the immune system, Wei Qi and Lung Qi The treatment strengthens the child s Zheng Qi for a faster recovery It would also allow fully expelling the pathogen. A pathogen remaining in the body might weaken the respiratory system, and cause complications later (asthma, mucus, recurring respiratory system infections) After the disease, and the acute phase, the root of the problem, like the weakness which allowed the pathogen to enter, and the remaining symptoms should be treated
Treating children with Tuina A short and simple treatment which is given 2-3 times a day, preferably starting with the initial symptoms The parents should be taught the course of treatment, so they may repeat it at home Parents who feel the have a therapeutic tool, which can help their children, will feel less frustrated while their children are sick. Such frustration often leads to unnecessary medical intervention Treating children with Tuina serves as a good starting point. It allows building trust between us, the child and his parents
Advantages of pediatric Tuina A message is being given: children learn that they can heal and feel better without any need for something external - drugs, herbs, needling Their own inner force is enough to recover Simple technique: easy to learn and apply, easy to teach the parents. Parents who know treatment tools will feel less frustration during child diseases Using Tuina is a good starting point for treatment. Start to connect to the child s Qi, feel him, diagnose, let him feel us, reduce the child s fear of treatment My own experience
General pediatric Tuina guidelines You: Be relaxed, calm, present in the moment of the treatment. Relax the hand, keep your elbow lower than your wrist Rhythmic movements, consistent and determined, send a message to the body Tuina influence the Qi. Bare in mind we enter the child s personal space Keep eye contact Explain: We are going to do that to reassure the child Pay attention to the reactions of the child. Notice if enjoys or is disturbed by the treatment. Most of the time the child will show us when it is enough for one technique You can apply when the child sitting on the parents. Older children can be asked to pay attention so they can teach the parent later on back home
General pediatric Tuina guidelines Boys- use hand technique on the left, girls use on the right One treatment is 10-12 different movements, each being done for 1-2 minutes Order: hand forehead abdomen legs back Continuous treatment, changeable, depended on the child s cooperation. One treatment per week for chronic case, followed by every day treatment of the parents at home. In acute cases, give 2-3 treatments per day. The treatment is being done over the clothes, can be done while the child sits in the parent s lap or during breast feeding or sleeping Don t treat over bruised or infected skin
Main techniques Fa Tui Fa Pushing Rou Fa Kneading Fen Tui Pushing apart Nie Fa Pinching Kou Fa Tapping with the fingertip Qia Fa Squeezing with the nail Bu- supplement, Qing - disperse
Main techniques Tui Fa Pushing Rubbing along a line, sliding over the skin Along lines, meridians Steady rhythm, uniform pressure, same direction Movement is more forceful than just brushing over the skin, but still gentle Bu =Supplement and reinforce form the periphery toward center of the body Qing =clear and drain from the center to the periphery
Main techniques Fen Tui Pushing apart Variant of tui fa From the center to the exterior Along lines opening from one point Used with both thumbs
Main techniques Rou Fa Kneading Produces internal wave At individual point with the tip of a finger or with full hand when used on the abdomen Deep but light and rhythmic Steady contact with the body, without sliding over or rubbing the skin Move subcutaneous tissues
Main techniques Nie Fa Pinching On the back or fingers Press firmly on finger joints When use on the back roll the skin between thumb and fingers
Main techniques Kou Fa Tapping with the fingertip On individual point Steady brisk Flexible movement, keeping your finger and wrist loose
Main techniques Qia Fa Squeezing with the nail On points Strong stimulation with the nail of the thumb
Pattern diagnosis- Invasion of External Pathogens Wind Cold Nasal obstruction, clear/ watery Shivers, low fever, little sweat Sensitivity to cold, pale complexion Tendency to diarrhea and abdominal pain Wind Heat Nasal obstruction, yellow/ thick High fever/ thirst/ profuse sweating Painful and red throat Tendency to constipation
Treatment protocols by patterns Expelling external pathogens Tui: Tian men Fen Tui: Kan Gong Yun: Tai Yang Rou: Er Hou Gao Gu Wind-cold: Rou: Wai Lao Gong Rou: Yi Wo Feng Rou: Er Shan Men Tui: San Guan For fever: guasha If cold attacks the middle jiao and intestine (diarrhea) Bu: Qi Jie GU Rou: Gui Wei Other protocols may be involved: Eliminating heat (constipation, Agitation, Fever) Supplementing Lung Qi, Spleen Qi, Kidney and Jing Transforming Phlegm
Treatment protocols by patterns Eliminating heat Tui: Tian He shui Qing: Xin Jing, Fei Jing, Gan Jing Kou: Xiao Tian Xin Rou: Nei Lao Gong (Pc8) If heat entered deep to Fu organs: Tui: Liu Fu For fever: Qing : Wu jing Tui: Shui Di Lao Yue guasha If heat attacks the intestines: Qing: Da Chang Jing, Xiao Chang Jing Qing: Qi Jie gu Rou: Gui Wei Other protocols may be involved: expelling external pathogens calming and clearing the shen freeing food accumulation
Locations Head Tian men heaven gate On the forehead between the eyebrows, starting from yin tang Tui toward the anterior hairline along the midline Calms the shen, transforms phlegm, opens the orifices, quiets wind Heat, phlegm, wind, agitation of the shen: disturbed sleep, restlessness, fever, headache, convulsions
Locations Head Kan gong water palace On the forehead one cun above the line of the eyebrows Fen tui from yin tang Releases the exterior, transforms phlegm, clear heat in the upper part of the body
Locations Head Er hou gao gu- big bone behind the ear Behind the earlobe at the apex of the mastoid process Rou Releases the exterior, benefits the ears and eliminates wind and heat Invasion of external pathogens: fever, earache, agitation
Locations Hand Wai lao gong outer palace of toil At the center of the dorsum of the hand Rou Warms yang in the abdomen and eliminates cold Cold, dampness and deficiency: diarrhea, vomiting and weakness
Locations Hand Yi wo feng wind nest On the dorsal aspect of the wrist, at the center of the crease Rou Warms and move Qi in the abdomen and eliminates cold Cold: abdominal pain, vomiting, colds, nasal congestion
Locations Hand Er shan men Two panels gate On the dorsum of the hand, two points, between 2 nd -3 rd and between 3 rd -4 th metacarpophalangeal joints Rou, Nie Release the exterior and promotes sweating, supplements Wei Qi Invasion of external pathogens: fever, cough and cold with absence of sweating
Locations Forearm San guan 3 passes A line on the radial border of the anterior aspect of the forearm Tui- from wrist to elbow Supplements qi and yang and eliminates cold Cold, dampness and def.: weakness, diarrhea, abdominal pain, colds, cough, disturbed sleep
Locations Forearm Tian he shui heavenly river water The central line on the anterior aspect of the forearm Tui - from the wrist to elbow Eliminates heat by cooling water Heat: restlessness, disturbed sleep, fever, eczema
Locations Forearm Liu fu 6 fu organs A line on the ulnar border of the anterior aspect of the forearm Tui from elbow to wrist Eliminates heat that has reached the interior and the Fu organs Excess fire and heat: high fever, sore throat, earache, dysentery, constipation, rashes and agitation
Locations Hand Wu jing- 5 channels On the palm, 5 lines, along the center of each finger Tui from the base of the palm to the tip of each finger (moistened with water) Eliminates wind and heat, harmonizes the 5 Zang Fu organs and transform food accumulation Invasion of external pathogens and food accumulation: fever, chest oppression, abdominal distention
Locations Hand Xiao tian xin small heavenly heart On the base of the palm between the Thenar eminence and hypothenar eminence Kou, Nie, Rou Clear heat and calm the shen Heat: agitation, restlessness, disturbed sleep, fever, eczema
Locations Hand Shui di lao yue fishing for the moon in the water On the palm, in an arc from the base of the little finger along the Hypothenar eminence to end at Pc-8. Tui Clear heat, bringing water to put out fire Heat, excess or deficient: acute fever or chronic lowgrade fever
Locations Back Gui wei tortoise tail At the tip of the coccyx Rou at the angle of 45 toward the umbilicus Regulates the intestines Changes of qi function in the intestine: diarrhea, constipation, irregular bowel movement
Locations Back Qi jie gu seven bones Midline of the back from L4 to the coccyx Tui Upward- Regulates the intestine while supplementing qi downward- Regulates the intestine while clearing heat Deficiency or heat: diarrhea, dysentery, constipation and irregular bowel movements